Arrangement Forms (Broward)

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We understand this is a difficult time, and our goal is to make this process as simple and supportive as possible. Please select the type of service you wish to arrange and complete the required forms. Once all information has been received, a director will contact you to review next steps and securely process payment.If you have any questions at any point, please don’t hesitate to reach out. We are here to help.
(954) 884-5770| contact@manorscremation.com

Service We Provide
Direct Cremation at time of Death - $890.00

Includes:
- Professional services of the Funeral Director and staff.
- Transfer of deceased person from location of death within:
  (Miami-Dade & Broward Counties) call for pricing outside of these counties
- Maintaining deceased person in a temperature-controlled unit until cremation can occur.
- Medical Examiners Authorization.
- Securing all Permits and filing of Death Certificate with the State.
- Cremation Process, (for deceased weighing less than 200 Lbs.)
- Please call for pricing on deceased weighing over 201 Lbs.
- Tree of life Wood Urn TSA approved (Cardboard Box)
- One (1) Certified Death Certificate.
- Notification to Social Security Administration.

Release Authorization for Removal of Decedent

NOTICE: THIS IS A LEGAL DOCUMENT. IT CONTAINS IMPORTANT FUNERAL ARRANGEMENT AUTHORIZATION FOR THE DECEDENT. READ THIS DOCUMENT CAREFULLY BEFORE SIGNING.
The undersigned hereby authorize:

CREMATIONS AMERICA, LLC DBA GUS CAMACHO JR. FUNERAL HOME
To Release the Remains of the Deceased

First NameMiddle NameLast NameSuffix
From Hospital or Location Address

Hospital or Location Name & Address

Apt No.

CityState / Province

Zip Code
I hereby certify that I am the individual with the nearest degree of relationship to the deceased, as defined under Florida Statute §497.005(43), and that I have the legal authority and responsibility to authorize Cremations America, LLC (d/b/a Gus Camacho, Jr. Funeral Home) to take custody of the deceased and to make the necessary funeral and disposition arrangements.
Name

First NameMiddle NameLast Name
Relationship
Signature
Date

MonthDayYear
Date

DEATH CERTIFICATE (DC) REQUISITION
Case No.
Date

MonthDayYear
Date
Name of Deceased

First NameMiddle NameLast NameSuffix
Number of DC Copies Ordered
Your arrangements include two (2) Death Certificates. If you would like additional copies, please indicate above.
Family Contact Name

First NameMiddle NameLast NameSuffix
Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Number
Please enter a valid phone number.Format: (000) 000-0000.
Special Instruction
Signature of Person Receiving DC's

AUTHORIZATION FOR CREMATION AND DISPOSITION

This is a legal document that contains important provisions regarding cremation. Please be advised that cremation is an irreversible process. Carefully review this document in its entirety before signing.
I/We, the undersigned, hereby certify, warrant, and represent that I/We have full legal right and authority, as a legally authorized person as defined under Florida Statute §497.005(37), to authorize the cremation, processing, and disposition of the remains of:
Name of Decedent

First NameMiddle NameLast NameSuffix
Date of Death

MonthDayYear
Date
Time

Hour Minutes

AM/PM Option
Place of Death

Street Address or Facility Name

Apt No.

CityState / Province

Zip CodeCountry
I/We hereby request and authorize Cremations America, LLC, doing business as Gus Camacho Jr. Funeral Home, to take custody of the deceased and to make all necessary arrangements for cremation at FCS. I/We further grant the Crematorium full authority to cremate the remains of the deceased and authorize the Crematorium to return the cremated remains to the Direct Disposal Establishment identified herein or as otherwise indicated below. I/We understand and agree that the services and obligations of FCS shall be deemed fully satisfied upon the return of the cremated remains to the possession and custody of Cremations America, LLC, doing business as Gus Camacho Jr. Funeral Home.

Please adhere to the following request:
Is special handling required:

If yes, please describe
Is a Witness Cremation requested?
Date

MonthDayYear
Date
Time

Hour Minutes

AM/PM Option
Number of Attendees
The cremation, processing, and disposition of the remains of the deceased authorized herein shall be performed in accordance with all applicable federal, state, and local laws, as well as the rules, regulations, and policies of FCS, and subject to the following terms and conditions:
- Cremation Container
  - The remains of the deceased shall be placed in a combustible, leak- resistant, rigid cremation container suitable for cremation.
- Implanted Mechanical or Radioactive Devices
  - Any mechanical or radioactive devices implanted in the remains of the deceased (including, but not limited to, pacemakers) must be removed prior to cremation. In the event that the remains contain such devices, I/We hereby authorize the Crematory, including its agents and employees, to remove any such devices either before or after cremation and to dispose of them in accordance with applicable laws and regulations.
  - Listed below are all known implanted mechanical or radioactive devices that the Crematory is authorized to remove and dispose of as indicated:
A)

B)

C)
- Destruction of Cremation Container
  - Any cremation container in which the remains are placed shall be completely and irreversibly destroyed during the cremation process. I/We authorize the Crematory to open the cremation chamber during the cremation process as necessary to reposition the remains in order to ensure a complete and thorough cremation.
- Personal Effects and Prosthetic Items
  - Articles including, but not limited to, body prostheses, dentures, dental bridgework, jewelry, dental fillings, dental gold caps, metal components of the cremation container, and other personal effects accompanying the remains may be destroyed during the cremation process. I/We further authorize the Crematory to separate and lawfully discard any remaining fragments or materials.
- Processing of Cremated Remains
  - Following cremation, the cremated remains—consisting primarily of bone fragments—shall be collected into a metal container and processed through a pulverizing machine. The processed remains shall then be placed in a plastic bag and enclosed within a temporary cardboard cremation container. I/We hereby authorize the Crematory to pulverize all bone fragments prior to placement in the temporary container.
- Unclaimed Cremated Remains
  - I/We agree that if the cremated remains of the deceased are not claimed within one hundred twenty (120) days from the date of cremation, Cremations America, LLC is authorized and directed to dispose of the unclaimed cremated remains in any lawful manner it deems appropriate.
- Indemnification and Hold Harmless
  - I/We agree to indemnify, release, and hold harmless the Crematory, the Direct Disposal Establishment, and their respective affiliates, agents, employees, and assigns from any and all losses, damages, liabilities, claims, or causes of action—including reasonable attorney’s fees and litigation expenses—arising out of or related to the cremation and disposition of the remains as authorized herein. This includes, but is not limited to, claims resulting from the failure to properly identify the remains of the deceased, disclose the presence of implanted mechanical or radioactive devices, or take possession of or make permanent arrangements for the disposition of the cremated remains.
Release Cremated Remains to:

First NameMiddle NameLast NameSuffix
Relationship
I/We warrants that all representations and statements contained in this form are true and correct, and that I/We have read and understand the provisions contained in this document
Signature of Person(s) Authorizing Cremation and Disposition
Signature
Name

First NameMiddle NameLast NameSuffix
Address
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
Signature
Name

First NameLast NameSuffix
Address
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
I have made the cremation arrangements for the deceased identified above in coordination with the legal next of kin and have received all required signatures for this Authorization for Cremation. I am signing below as a witness.
Funeral Director or Direct Disposer Signature
Name

First NameLast NameSuffix
Date

MonthDayYear
Date
THIS PAGE MUST BE SIGNED IN THE PRESENCE OF A FUNERAL HOME REPRESENTATIVE, DIRECT DISPOSER, OR CREMATORY STAFF MEMBER, OR IN THE PRESENCE OF A NOTARY PUBLIC.
State of:
County of:
Date:   Date
Before me, a Notary Public in and for said County and State, personally appeared who executed this document and was known by me   Personally    Produced identification
Type of ID:

GENERAL PRICE LIST

These prices are effective April 1, 2026 but are subject to change without notice. The goods and services shown below are those we can provide to our customers. You may choose only the items you desire. However, any cremation arrangements you select will include a charge for our basic services and overhead. If legal or other requirements mean you must buy any items you did not specifically ask for, we will explain the reason in writing on the statement we provide describing the funeral goods and services you selected. Please note there may be additional charges for extra expenses and special request items not listed such as flowers, outside expenses, etc.
Basic Services of Funeral Director and Staff.............................................$425.00

Our services include: conducting the arrangement conference; consulting with family in person or via online submission; preparing and filing necessary notices; obtaining necessary authorizations and permits; coordinating with hospital, crematory and other third parties. This fee for our basic services and staff will be added to the total cost of the funeral arrangements you
select.

Please note that embalming is not required for direct cremation and our establishment does not provide embalming or funeral services of any kind or immediate burials. It is our policy to require refrigeration of a

non-embalmed body.

Please note that Refrigeration is required for a non-embalmed body. If cremation is delayed by legal representative not returning proper documents longer that 4 (four) days, an additional charge of $200.00 per day will be added to total cost of arrangement.

Please note that bodies refrigerated with our establishment for more that 1 (one) day from date of death and
family wishes to go and use a different establishment for services, a $200.00 per day charge will be incurred in addition to removal fee.

Transfer of remains from place of death to crematory……………………………....……$495.00
Outside Miami-Dade & Broward County additional is based on county of death $190.00 to $900.00

Direct Cremation (with Alternative Container for deceased less than 200 lbs.)..................................................................................................$1490.00

Direct Cremation (with Alternative oversized Container for deceased over 201 lbs.)................................................................................$1980.00 to $2390.00

Our charge for a direct cremation (without ceremony) includes: basic services of Funeral Director and staff; a proportionate share of overhead costs; removal of remains within Miami-Dade and Broward County; transportation to crematory; refrigeration; necessary authorizations and permits, alternative container,
cremation process, one (1) Certified Death Certificate and Medical Examiner Authorization Fee.

If you want to arrange a direct cremation, you can use an alternative container. Alternative containers encase the body and can be made of materials like cardboard or composition materials. The container we provide is a cardboard container approved and is required by the State of Florida & Crematory.

Urns…………………………………………………………….….…................……..$100.00 to $3,500.00
Preparation of Insurance Forms and Coordination……..…………………………………..$320.00
F.D. Coordination of select Veterans Services………………......……………………………$390.00

Other Frequently Requested Items and Their Prices:
Register Book (Plain)….............................................................starting at $35.00
Prayer Cards (per 48 plain)……………...…………….........……………..……..……………... $60.00
Prayer Cards (per 48 Laminated)………….………..........…………………….…………………$75.00
Acknowledgement (per 25 cards).………….…….........……………………….….……….……$40.00
Memorial Packages………………………………………......…………..............…starting at $95.00
Keepsakes……….……………………………………………...........……..……....…..starting at $89.00
Mailing of ashes via USPS Express Mail (domestic only) ….........................$155.00
Scattering of ashes (no family present)….……………....................................$410.00
Delivery of ashes (within Miami-Dade & Broward County)...…………........….....$95.00
Placement of Cremated Remains (in urn provided by the family)……….......…..$35.00

I certify that I have read and understood the price list of service offered by Cremations America Of Broward, LLC DBA Manors Cremation.
Signature
Date

MonthDayYear
Date
Should be Empty:

We’re Here to Help

Service We Provide

1. DECEDENT'S INFORMATION

2. PLACE OF DEATH

3. DECEDENT'S RESIDENT ADDRESS

3.1 SURVIVING SPOUSE

4. EMPLOYMENT HISTORY (DO NOT ENTER RETIRED)

5. RACE (SELECT ALL THAT APPLY)

6. HISPANIC/HAITIAN ORIGIN

7. HIGHEST LEVEL OF EDUCATION

7.1. ARMED FORCES

8. FATHER'S / PARENT'S NAME PRIOR TO FIRST MARRIAGE

9. MOTHER'S / PARENT'S NAME PRIOR TO FIRST MARRIAGE

10. INFORMANT (LEGAL NEXT OF KIN)

To BE COMPLETED BY FUNERAL DIRECTOR

Release Authorization for Removal of Decedent

DEATH CERTIFICATE (DC) REQUISITION

AUTHORIZATION FOR CREMATION AND DISPOSITION

Signature of Person(s) Authorizing Cremation and Disposition

GENERAL PRICE LIST